| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $289.72 | $4,933.00 | $5,757.00 | |
BCBS
| Facility | $3,928.29 | $4,585.50 | $6,246.71 | |
Health Alliance Plan
| Facility | $123.12 | $4,933.00 | $5,757.00 | |
United
| Facility | $4,069.00 | $8,847.00 | $10,652.00 |